Provider Demographics
NPI:1962096818
Name:BREWSTER DENTAL ARTS PLLC
Entity type:Organization
Organization Name:BREWSTER DENTAL ARTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:QUINTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-896-5732
Mailing Address - Street 1:PO BOX 1108
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-7108
Mailing Address - Country:US
Mailing Address - Phone:508-896-5732
Mailing Address - Fax:508-896-3134
Practice Address - Street 1:2542 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631
Practice Address - Country:US
Practice Address - Phone:508-896-5732
Practice Address - Fax:508-896-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental